Rheumatic Manifestations of Gastrointestinal and Hepatobiliary Diseases
1. Spondyloarthritis (SpA) occurs in 25% of patients with inflammatory bowel disease (IBD), most commonly in those with extensive colonic involvement.
2. Consider bowel disease in any patient with an intermittent, inflammatory arthritis regardless of presence or absence of gastrointestinal symptoms.
3. Episodes of peripheral SpA may or may not coincide with flares of bowel disease, while axial SpA occurs independent of bowel disease activity.
4. Autoimmune hepatitis (AH) presenting with polyarthritis and a positive antinuclear antibody (ANA) can mimic systemic lupus erythematosus (SLE).